Otoplasty for prominent ears with combined techniques

Prominent ears is the most common congenital malformation in the head and neck region, and over 200 different correction techniques have been published. This demonstrates both the substantial effort devoted to ensuring an harmonious, natural, stable result and the lack of agreement over the approaches to achieve this goal. We present our experience in 42 patients using a combined technique that includes: (a) a large cutaneous excision in the upper part of the helix and in the lobule area to make the ear lie closer to the head, instead of the conventional elliptical excision, (b) closed anterior scoring, according to Stenstrom's technique, to reconstruct the antihelix, possibly combined with Mustardé sutures, (c) removal of the posterior auricular muscle to make the concha fit to the mastoid in a stable way, and (d) a semilunar excision of conchal cartilage by Mustardé's technique if the concha does not fit satisfactorily. This technique has proven to be safe, not particularly difficult to perform, with few complications, and can be used even for very prominent ears with good, stable long-term results.